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A new report from Shasta County Public Health shows the alarming impact heroin has started to make on the community.

While the report also details some encouraging trends around opioid use in the area, it found that deaths from the drugs went back up in 2017 after declining over the past few years, and that heroin specifically was driving a dramatic uptick in overdoses and admission to addiction programs.

The local data comes as a national database of opioid prescriptions by county from the Washington Post has been making headlines. And although some of the Post's Drug Enforcement Agency data for Shasta County is staggering, it's also close to a decade old.

The county's latest opioid snapshot — as well as a separate report obtained by the Record Searchlight — gives a more current look at the state of opioids in the area.

More people — especially older adults — are dying from opioids in Shasta County, but numbers are still slightly down from what they were a decade ago. In addition, the cause of those deaths shows more people are using heroin and other illegal opioids. Only 1.6 percent of unintentional fatal overdoses used to be caused by illicit drugs, while from 2013 to 2017, it grew to 15.8 percent.

At one time, more prescription pills were flowing into the area than almost anywhere in the West, but local prescriptions have gone down in recent years.

The county still had over a 600-percent increase in heroin overdoses during the same period — a possible indicator that the nationwide opioid crisis is turning people onto illicit substances when their prescriptions for pills run out.

Similarly, the vast majority of people seeking treatment for opioid addiction in the county were doing so because of heroin use — a reversal from years past, when other types of opioids represented most treatment admissions.

Here’s a breakdown of those and some other figures on opioid use in Shasta County:

Deaths are both down and up

There were 29 local opioid-related deaths in 2017, per county data. That compares to a high of 33 in 2009 and a low of 18 in both 2011 and 2015. Those numbers are small enough that they’re not considered statistically significant.

Those deaths show that heroin and other illegal opioids are gaining ground in the area. Illicit opioids were behind almost 16 percent of accidental opioid deaths from 2013 to 2017, compared with only 1.6 percent from 2008 to 2012.

Over half of those who died during the four-year period were between the ages of 45 and 64.

On top of that, illicit opioids are the only category where deaths from the drugs increased on average over the past five years, though the illicit category was still lower than deaths for both prescription drugs and drugs linked to a mixture of substances. Prescription opioids caused 17.8 percent of deaths from the drug from 2013 to 2017, and most people — 53.5 percent — died from a mixture of opioids and other substances.

Health officials believe fewer people might be dying compared to the county's all-time high because there's more awareness now around lifesaving antidotes like Naloxone, though.

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Heroin overdose.(Photo: Joe Szydlowski)

Prescription opioid pills per resident were once staggering, but that may not be the case anymore

At one point in the past decade, Shasta County had more prescription opioid pills per person than almost anywhere in the West.

There were over 117 million prescription opioid pills in Shasta County from 2006 to 2012, the most recent years covered in the Post’s database. That comes out to an average of 94.5 pills per person annually, the Post reported. Not just in California, but on the entire West Coast, only Lake County had a higher rate with its 97.3 pills per resident during that period. Shasta County also had the fifth-worst amount of pills per resident west of Kansas during that period.

The county had already sued some opioid makers and distributors in response to “suspicious” shipments to the area before the Post’s findings came out.

Still, Jeff Van Ausdall, an epidemiologist with the county, said the area's amount of actual prescriptions has gone down significantly in recent years. In 2017, there were 198,560 opioid prescriptions filled in the county, a 9-percent decrease from the year before. The average prescription was for 85 pills, per the county. That represented an average of 70 pills per person in the county for 2017, well under the 2006 to 2012 findings from the Post.

Overdoses skyrocket

While prescription pills might be down in the area, heroin overdoses are up.

Similar to the pattern of opioid deaths in the county, all types of opioid-related emergency-room visits were up except for those related to methadone.

Heroin overdoses in particular saw a dramatic increase at the ER. In 2016, the most recent year for which county data has available, there were 54 trips to the ER for heroin poisoning in the county, while in 2007, there was only one. That makes 2016’s rate per 100,000 residents 30.3 compared to only 0.6 in 2007.

While some of the county’s opioid use is fairly unique, that uptick in heroin mirrors a national trend.

“We’re just echoing the rest of the country,” Van Ausdall said.

Going in the opposite direction, methadone ER visits peaked at 18 in 2007 and, other than the three visits in 2009, they’ve never been lower than the four visits in 2016.

Total ER visits for opioid poisoning were also up significantly, with 279 visits in 2016 compared to a low of just 65 in 2009.

White adults under 35 are most of the overdose victims

Most opioid-overdose victims in the county were white and between 18 and 34, the county's report shows.

The victims were 93 percent white (even though the county is only about 81 percent white), and 46 percent of them made up that age bracket (even though that only accounts for 21 percent of the county's population).

The difference between sexes was less staggering.

From 2013 to 2017, 264 of the overdose visits to the ER for opioids came from men, while 217 were from women.

Hospitalizations are down, but treatment is up dramatically — mostly because of heroin

The rate of admission for opioid-use treatment from 2013 to 2017 was 276.4 per 100,000 residents, a dramatic increase from 2008 to 2012's rate of 135, county data show. And the vast majority of those people were seeking treatment for heroin use.

Of the people who sought treatment in 2013 to 2017, the rate for heroin was 203.7 per 100,000 residents compared to just 37.9 for the next biggest offender: synthetic opioids and certain other types of opioids. Oxycodone and Oxycontin had a treatment rate of 22.1, while methadone only had a rate of 12.7 in those years. Contrast that with 2008 to 2012, when there was only a treatment rate for heroin of 33.8, and the biggest drug driving treatment was the other/synthetics category with a rate of 46.6.

Meanwhile, the rate of hospitalizations actually slightly decreased.

From 2008 to 2012, opioid hospitalizations averaged at 39.7 for men and 43.3 for women per 100,000 residents. In 2013 to 2017, those rates went down respectively to 32.9 and 29.3.

Who's behind the pills?

The top five local pharmacies for opioids from 2006 to 2012 were Walgreens in Redding (8,627,400 pills), Owens in Redding (8,435,330 pills), Costco in Redding (6,754,020 pills), Ferry’s Pharmacy in Anderson (4,960,910 pills) and Owens in Anderson (4,800,800 pills).

The top manufacturer of those pills in the county was Actavis Pharma, Inc. (which made 43,159,060 of them), while the top distributor was McKesson Corporation (which distributed 41,784,650 of them).

This image was created using coroner's reports for opioid-related overdoses in 2016(Photo: Photo illustration)

Alayna Shulman covers a little bit of everything for the Record Searchlight. In particular, she loves writing about the issues of this community through long-form storytelling. Her work often centers on local crime, features and politics, and has won awards for best writing, best business coverage and best investigative reporting in the California News Publishers Association's Better Newspapers Contest. Follow her on Twitter (@ashulman_RS), call her at 530-225-8372 and, to support her work, please subscribe.